| NPI | 1013998582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 55795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 72672) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 72672) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2011-07-06 |